Ventura Duenas v. Papillion Foods

- 899 -
Nebraska Court of Appeals Advance Sheets
32 Nebraska Appellate Reports
VENTURA DUENAS v. PAPILLION FOODS
Cite as 32 Neb. App. 899
Marlene Ventura Duenas, appellee,
v. Papillion Foods, appellant.
___ N.W.3d ___
Filed May 21, 2024. 	No. A-23-563.
1. Workers’ Compensation: Appeal and Error. Pursuant to Neb. Rev.
Stat. § 48-185 (Reissue 2021), an appellate court may modify, reverse,
or set aside a compensation court decision only when (1) the compensa-
tion court acted without or in excess of its powers; (2) the judgment,
order, or award was procured by fraud; (3) there is not sufficient compe-
tent evidence in the record to warrant the making of the order, judgment,
or award; or (4) the findings of fact by the compensation court do not
support the order or award.
2. ____: ____. On appellate review, the factual findings made by the trial
judge of the compensation court have the effect of a jury verdict and
will not be disturbed on appeal unless clearly wrong.
3. Workers’ Compensation: Judgments: Appeal and Error. In testing
the sufficiency of the evidence to support the findings of fact in a work-
ers’ compensation case, an appellate court considers the evidence in the
light most favorable to the successful party, every controverted fact must
be resolved in favor of the successful party, and the appellate court gives
the successful party the benefit of every inference reasonably deducible
from the evidence.
4. Workers’ Compensation: Proof. In order to recover under the Nebraska
Workers’ Compensation Act, a claimant has the burden of proving by a
preponderance of the evidence that an accident or occupational disease
arising out of and occurring in the course of employment proximately
caused an injury which resulted in disability compensable under the act.
5. Workers’ Compensation: Expert Witnesses. If the nature and effect
of a claimant’s injury are not plainly apparent, then the claimant must
provide expert medical testimony showing a causal connection between
the injury and the claimed disability.
6. ____: ____. It is the role of the compensation court as the trier of fact to
determine which, if any, expert witnesses to believe.
Nebraska Supreme Court Online Library
www.nebraska.gov/apps-courts-epub/
10/14/2026 07:45 AM CDT

- 900 -
Nebraska Court of Appeals Advance Sheets
32 Nebraska Appellate Reports
VENTURA DUENAS v. PAPILLION FOODS
Cite as 32 Neb. App. 899
7. Workers’ Compensation. Whether an injury arose out of and in the
course of employment must be determined from the facts of each case.
8. Workers’ Compensation: Proof. The two phrases “arising out of” and
“in the course of” in Neb. Rev. Stat. § 48-101 (Reissue 2021) are con-
junctive; in order to recover, a claimant must establish by a preponder-
ance of the evidence that both conditions exist.
9. ____: ____. The “in the course of” requirement tests the work con-
nection as to the time, place, and activity; that is, it demands that the
injury be shown to have arisen within the time and space boundaries of
employment and in the course of an activity whose purpose is related to
employment.
10. Workers’ Compensation: Words and Phrases. The phrase “arising
out of,” as used in Neb. Rev. Stat. § 48-101 (Reissue 2021), describes
the accident and its origin, cause, and character, i.e., whether it resulted
from the risks arising within the scope of the employee’s job.
11. Workers’ Compensation. All risks causing injury to an employee can
be placed within three categories: (1) employment related—risks dis-
tinctly associated with the employment; (2) personal—risks personal
to the claimant, e.g., idiopathic causes; and (3) neutral—a risk that
is neither distinctly associated with the employment nor personal to
the claimant.
12. ____. Harm that arises from risks distinctly associated with the employ-
ment is universally compensable.
13. ____. Generally, harm that can be attributed solely to personal or idio-
pathic causes is universally noncompensable.
14. ____. Harm that arises from neutral risks is generally compensable.
15. ____. Temporary disability benefits under the Nebraska Workers’
Compensation Act are discontinued at the point of maximum medical
improvement, because a disability cannot be both temporary and perma-
nent at the same time.
16. Workers’ Compensation: Time. The date of maximum medical
improvement for purposes of ending a workers’ compensation claimant’s
temporary disability is the date upon which the claimant has attained
maximum medical recovery from all of the injuries sustained in a par-
ticular compensable accident.
17. Workers’ Compensation. When an injured employee has reached maxi-
mum medical improvement, any remaining disability is, as a matter
of law, “permanent,” within the meaning of the Nebraska Workers’
Compensation Act.
18. ____. Whether a workers’ compensation claimant has reached maximum
medical improvement is a question of fact.
19. Workers’ Compensation: Appeal and Error. Workers’ Comp Ct. R. of
Proc. 11 (2021) ensures that compensation court orders are sufficiently

- 901 -
Nebraska Court of Appeals Advance Sheets
32 Nebraska Appellate Reports
VENTURA DUENAS v. PAPILLION FOODS
Cite as 32 Neb. App. 899
clear in addressing the parties’ requested relief so that an appellate court
can review the evidence relied upon by the trial judge in support of his
or her findings.
Appeal from the Workers’ Compensation Court: James R.
Coe, Judge. Affirmed in part, and in part vacated and remanded
with directions.
Charles L. Kuper, of Kuper, Wenninghoff & Block, P.C.,
L.L.O., for appellant.
Michael P. Dowd, of Dowd & Corrigan, L.L.C., for appellee.
Pirtle, Chief Judge, and Riedmann and Welch, Judges.
Riedmann, Judge.
INTRODUCTION
Papillion 	Foods 	appeals 	the 	award 	of 	the 	Workers’
Compensation Court finding Marlene Ventura Duenas (Duenas)
suffered a work-related injury that left her permanently and
totally disabled. Papillion Foods challenges the compensation
court’s causation and permanency determinations and asserts
the award does not provide a basis for meaningful review
in violation of Workers’ Comp. Ct. R. of Proc. 11 (2021)
(Rule 11).
We affirm the compensation court’s findings of causation;
however, because we conclude that the compensation court’s
award did not provide a meaningful basis for appellate review
of its award of permanent and total disability benefits, we
vacate that portion of the award and remand the matter to the
compensation court with directions to enter an order in com-
pliance with Rule 11.
BACKGROUND
Prior History.
Duenas, who is from El Salvador, began working at Papillion
Foods on April 5, 2021. She moved to the United States
in 2015 and does not speak English. Duenas had previous

- 902 -
Nebraska Court of Appeals Advance Sheets
32 Nebraska Appellate Reports
VENTURA DUENAS v. PAPILLION FOODS
Cite as 32 Neb. App. 899
workers’ compensation claims that stemmed from injuries in
2016 and 2017 involving her right knee, left knee, and lower
back. She had previously been diagnosed with arthritis in both
of her knees. On April 2, 2021, Duenas visited her physician
for a wellness examination and had no complaints related to
the arthritis or prior injuries to her knees or lower back.
Work Injury.
On April 8, 2021, Duenas was working at Papillion Foods
and was issued rubber boots to put over her regular shoes.
Duenas testified that the boots she was issued were too large
and that she was told that was the only size available. Duenas
stated that while walking down the stairs to go back to the
workline after lunch, the boots bent back. She felt a “pop”
in her left knee that radiated from back to front, and she was
unable to walk. Duenas’ knee was swollen that evening, and
she still could not walk.
Ronald Dippel, the safety manager for Papillion Foods,
investigated the accident. Dippel spoke with Duenas and
another employee, and his understanding was that Duenas
was injured coming down some stairs after lunch, that she felt
pain, and that she then reported it. Dippel testified that Duenas
never mentioned anything about her boots, nor did she make
any gestures indicating that one of her boots bent. He also
stated that at the time, Duenas was unsure what had caused
her injury.
The accident report completed by Duenas stated that she
“was coming back from my lunch and going down the stairs
when my left foot bent.” The report makes no mention of
boots. Dippel stated that it was not until April 13, 2021, that
Duenas said her boot curled underneath her foot, which she
believed caused the injury. Dippel testified that if an employee
had said the employee’s boots were too large, a smaller size
would have been issued immediately because the company
recognizes that it is a potential slip hazard and there would
have been a variety of sizes available.

- 903 -
Nebraska Court of Appeals Advance Sheets
32 Nebraska Appellate Reports
VENTURA DUENAS v. PAPILLION FOODS
Cite as 32 Neb. App. 899
Medical Care and Treatment.
The day after the accident, Duenas still could not walk and
did not go to work. She was examined by the company health
service and reported that “she was coming down the stairs at
work and when she came to the bottom stair she felt a pop in
the back of her left knee.” Duenas was allowed to return to
work with a knee sleeve, a thigh compression wrap, and the
use of a walker or crutches.
Due to lack of improvement, an MRI was performed in
May 2021 that revealed a torn meniscus. Duenas was referred
through her employer to Dr. Brian Conroy, an orthopedic spe-
cialist. Duenas reported to him that “she was walking down the
stairs while at work, when she bent her knee in a non typical
fashion.” Conroy injected her knee with cortisone and recom-
mended she return to work with the assistance of crutches and
a knee brace.
On June 15, 2021, Conroy issued a causation report in
which he opined that Duenas’ pain and disability were related
to her fall at work, and not to her preexisting arthritis. He also
recommended that Duenas undergo surgery on her knee. The
surgery on Duenas’ left knee was performed on August 18,
and she was given a prescription for a wheelchair to use dur-
ing her recovery.
Duenas attended physical therapy, and at various times, it
was noted that she was having pain in both knees. It was also
noted that she had pain in her lower back from sitting in the
wheelchair for so long. Duenas testified that she began to expe-
rience back pain and that she also would use her right knee
more to avoid pressure on her left knee. A physical therapy
report from October 2021 reflected that Duenas had started
back at work and was very sore.
Various work restrictions were provided during the course
of Duenas’ treatment. Following her August 18, 2021, surgery,
she was off work until October 1. At that time, she returned to
work, but she insisted she needed to remain in a wheelchair
at all times. Conroy clarified that Duenas could perform only

- 904 -
Nebraska Court of Appeals Advance Sheets
32 Nebraska Appellate Reports
VENTURA DUENAS v. PAPILLION FOODS
Cite as 32 Neb. App. 899
sitting work, but that it could be in a desk chair, and she did
not need to sit only in her wheelchair.
On October 12, 2021, Conroy noted that Duenas was expe-
riencing back pain. It was his opinion that the back pain was
a direct result of the work-related knee injury and treatment,
specifically the non-weight-bearing status and then progressive
weight bearing. On October 21, Conroy continued Duenas’
restriction to only sitting work. A physical therapy report from
November 22 stated that Duenas had a significant increase
in pain in both knees and her lower back. On November 23,
Conroy restricted Duenas to a total of 8 hours each workday,
with 4 hours a day sitting and 4 hours a day standing, alternat-
ing between sitting and standing throughout the shift. She also
could not squat, kneel, twist, or lift more than 10 pounds, but
could walk 100 yards to and from a workstation.
In Conroy’s progress note of January 11, 2022, he stated that
he gave Duenas the option of a cortisone injection or perma-
nent restrictions. He reported that Duenas stated she wanted a
functional capacity evaluation and permanent restrictions, but
then stated she wanted to continue therapy. Ultimately, it was
decided that Duenas would try therapy for another month and
continue the work restrictions in place and then would be eval-
uated in another month. Duenas’ work restrictions remained
the same, and she was to continue physical therapy with a
recheck with Conroy in a month. He anticipated that at that
time, she would be at maximum medical improvement.
Duenas’ May 26, 2022, followup appointment with Conroy
was canceled because the workers’ compensation insurance
carrier did not approve the visit. Duenas testified that on May
27, she was called to the Papillion Foods’ office and was told
she was being placed in a different job but that she did not
believe it met her restrictions. Duenas stated she told Papillion
Foods that she needed to be somewhere that she could be sit-
ting all the time, but that “they didn’t want to respect that.”
May 27 was the last day Duenas worked at Papillion Foods.
Dippel testified that the job that Duenas was offered was

- 905 -
Nebraska Court of Appeals Advance Sheets
32 Nebraska Appellate Reports
VENTURA DUENAS v. PAPILLION FOODS
Cite as 32 Neb. App. 899
within her restrictions and that when they offered that job
to her, she declined. Dippel was unaware of any time that
Papillion Foods did not honor Duenas’ work restrictions.
At the request of Papillion Foods, Dr. Ryan Arnold evalu-
ated Duenas on June 3, 2022, and issued a report finding that
Duenas had osteoarthritis of the left knee and morbid obesity
and that these were not specifically related to the April 8,
2021, injury. He opined that Duenas’ continued symptoms
were the result of the chronic underlying progressive osteo-
arthritis condition of her knee and that further medical treat-
ment would be treating that chronic underlying condition. In
his opinion, she had reached maximum medical improvement
regarding the April 8 injury.
Duenas returned to Conroy on June 14, 2022, at which
time she was “limping quite badly.” Conroy ordered an MRI
of her left knee and restricted her to sitting work only. She
returned to Conroy on July 12 to review the MRI findings. At
that time, she had complaints of pain in both knees. Conroy
opined that although Duenas had preexisting arthritis in
her right knee, it was exacerbated by the injury in her left
knee, which also caused her back to hurt. He injected her
right knee.
On August 21, 2022, Conroy responded to a question-
naire from Duenas’ attorney. The questionnaire asked whether
Duenas was at maximum medical improvement and, if so, to
state the impairment of her left lower extremity, right lower
extremity, and back (body as a whole). Conroy responded that
Duenas had a 25-percent whole person impairment.
In October 2022, Ted Stricklett, a court-appointed vocational
counselor, issued a loss of earning capacity report, and he
determined, based on her restrictions of sitting work only, that
she had sustained a total loss of earning capacity.
On February 26, 2023, Conroy responded to several ques-
tions posed by Papillion Foods’ attorney. He indicated that had
he known of Duenas’ prior workers’ compensation claims, he
would have inquired further and requested records. Conroy

- 906 -
Nebraska Court of Appeals Advance Sheets
32 Nebraska Appellate Reports
VENTURA DUENAS v. PAPILLION FOODS
Cite as 32 Neb. App. 899
was asked whether, based on evidence of Duenas’ prior work-
ers’ compensation claims and other information regarding
her lifestyle and walking abilities that Papillion Foods had
detailed in a letter, his opinion would remain the same as it
was on August 21, 2021. Conroy stated that Duenas was a
“difficult person to assess,” but that she objectively demon-
strated the inability to walk when he saw her in the clinic. He
stated that what was most outstanding to him was Duenas’
“gait derangement” and that when he saw her in the clinic,
she could not safely walk without a walker. He stated that if it
were demonstrated she could ambulate better, that that may be
a reason to reevaluate the impairment rating.
A functional capacity evaluation was conducted on April
28, 2023, which found that Duenas had restrictions of occa-
sional standing and walking but that she also needed to
use a supporting surface with all walking activities. Conroy
agreed these were medically reasonable and necessary restric-
tions due to Duenas’ work accident and supporting activities.
However, due to the results of the April 28 evaluation, he
lowered Duenas’ whole body impairment rating to 20 percent.
Stricklett updated his loss of earning capacity evaluation fol-
lowing the results of the updated functional capacity evalua-
tion, but he continued to opine that Duenas experienced a total
loss of earning capacity.
Compensation Court Award.
The compensation court described causation as “close,”
but accepted Duenas’ version that she was injured when
walking down the stairs and slipped due to the oversized
boots Papillion Foods had issued to her. It noted Conroy
recognized Duenas’ preexisting arthritis but stated that based
upon reasonable medical certainty, the pain and disability she
was experiencing were from the fall at work, and that her
back pain was a result of the work-related knee injury. The
compensation court gave Stricklett’s assessment a rebuttable
presumption of correctness, and it accepted his opinion that

- 907 -
Nebraska Court of Appeals Advance Sheets
32 Nebraska Appellate Reports
VENTURA DUENAS v. PAPILLION FOODS
Cite as 32 Neb. App. 899
Duenas had a 100-percent loss of earning capacity, despite the
findings in the later functional capacity evaluation.
The compensation court ordered Papillion Foods to pay
Duenas permanent and total disability benefits from the date
Duenas last worked at Papillion Foods on May 27, 2022, to
the date of the hearing, and for so long in the future as Duenas
remained permanently and totally disabled. It also ordered
Papillion Foods to pay outstanding medical expenses and found
that Duenas was entitled to future medical care as set forth in
Conroy’s report of “July 12 [sic].” Papillion Foods appeals.
ASSIGNMENTS OF ERROR
Papillion Foods assigns, reordered, that the compensation
court erred as a matter of law and fact by (1) determining that
Duenas suffered an accident arising out of and in the course
of her employment with Papillion Foods and (2) adopting the
opinion of Conroy. It also assigns that the compensation court
(3) erred in determining that Duenas is permanently totally
disabled and (4) failed to issue an award that provides a basis
for meaningful review, in violation of Rule 11.
STANDARD OF REVIEW
[1] Pursuant to Neb. Rev. Stat. § 48-185 (Reissue 2021), an
appellate court may modify, reverse, or set aside a compen-
sation court decision only when (1) the compensation court
acted without or in excess of its powers; (2) the judgment,
order, or award was procured by fraud; (3) there is not suffi-
cient competent evidence in the record to warrant the making
of the order, judgment, or award; or (4) the findings of fact
by the compensation court do not support the order or award.
Cajiao v. Arga Transport, 30 Neb. App. 700, 972 N.W.2d
433 (2022).
[2,3] On appellate review, the factual findings made by
the trial judge of the compensation court have the effect of a
jury verdict and will not be disturbed on appeal unless clearly
wrong. Id. In testing the sufficiency of the evidence to sup-
port the findings of fact in a workers’ compensation case, an

- 908 -
Nebraska Court of Appeals Advance Sheets
32 Nebraska Appellate Reports
VENTURA DUENAS v. PAPILLION FOODS
Cite as 32 Neb. App. 899
appellate court considers the evidence in the light most favor-
able to the successful party, every controverted fact must be
resolved in favor of the successful party, and the appellate
court gives the successful party the benefit of every inference
reasonably deducible from the evidence. Id.
ANALYSIS
[4] 	In 	order 	to 	recover 	under 	the 	Nebraska 	Workers’
Compensation Act, a claimant has the burden of proving by a
preponderance of the evidence that an accident or occupational
disease arising out of and occurring in the course of employ-
ment proximately caused an injury which resulted in disability
compensable under the act. Hintz v. Farmers Co-op Assn., 297
Neb. 903, 902 N.W.2d 131 (2017).
[5,6] If the nature and effect of a claimant’s injury are not
plainly apparent, then the claimant must provide expert medi-
cal testimony showing a causal connection between the injury
and the claimed disability. Id. The rule in this jurisdiction
is that triers of fact are not required to take the opinions of
experts as binding on them. Id. It is the role of the compensa-
tion court as the trier of fact to determine which, if any, expert
witnesses to believe. Id.
Accident in Course of Employment.
Papillion Foods assigns that the compensation court erred
in determining that Duenas suffered an accident arising out of
and in the course of her employment. It attacks both Duenas’
credibility in her recitation of how the injury occurred and the
legal sufficiency of Conroy’s opinion. We find no error in the
compensation court’s determination.
[7-9] Whether an injury arose out of and in the course of
employment must be determined from the facts of each case.
Webber v. Webber, 28 Neb. App. 287, 942 N.W.2d 438 (2020).
The two phrases “arising out of” and “in the course of” in
Neb. Rev. Stat. § 48-101 (Reissue 2021) are conjunctive; in
order to recover, a claimant must establish by a preponder-
ance of the evidence that both conditions exist. Webber v.

- 909 -
Nebraska Court of Appeals Advance Sheets
32 Nebraska Appellate Reports
VENTURA DUENAS v. PAPILLION FOODS
Cite as 32 Neb. App. 899
Webber, supra. The “in the course of” requirement tests the
work connection as to the time, place, and activity; that is, it
demands that the injury be shown to have arisen within the
time and space boundaries of employment and in the course
of an activity whose purpose is related to employment. Id.
[10-14] The phrase “arising out of,” as used in § 48-101,
describes the accident and its origin, cause, and character, i.e.,
whether it resulted from the risks arising within the scope of
the employee’s job. Webber v. Webber, supra. All risks caus-
ing injury to an employee can be placed within three catego-
ries: (1) employment related—risks distinctly associated with
the employment; (2) personal—risks personal to the claimant,
e.g., idiopathic causes; and (3) neutral—a risk that is neither
distinctly associated with the employment nor personal to
the claimant. Id. Harm that arises from risks distinctly asso-
ciated with the employment is universally compensable. Id.
Generally, harm that can be attributed solely to personal or
idiopathic causes is universally noncompensable. Id. Harm that
arises from neutral risks is generally compensable. Id.
Here, the compensation court stated that it accepted Duenas’
testimony that she was injured when she walked down the
stairs and slipped due to the oversized boots that Papillion
Foods issued to her. As the trier of fact, the workers’ compen-
sation court is the sole judge of the credibility of witnesses
and the weight to be given their testimony. Parks v. Hy-Vee,
307 Neb. 927, 951 N.W.2d 504 (2020). Our standard of review
requires us to consider the evidence in the light most favor-
able to the successful party. See Cajiao v. Arga Transport, 30
Neb. App. 700, 972 N.W.2d 433 (2022). Accepting Duenas’
testimony, we believe it shows her accident arose out of and
in the course of her employment. She was issued the boots as
part of her work the day of the accident, and due to their size,
they bent back and caused her to slip, which led to immediate
pain in her left knee.
Papillion Foods challenges Duenas’ version of the accident
and argues that it is not credible because her initial reports

- 910 -
Nebraska Court of Appeals Advance Sheets
32 Nebraska Appellate Reports
VENTURA DUENAS v. PAPILLION FOODS
Cite as 32 Neb. App. 899
of injury fail to mention the boots as the cause of her knee
injury. However, in her initial written report, she indicated that
her “left foot bent.” Considering that Duenas does not speak
English, we cannot conclude that her report is inconsistent with
her claim. Furthermore, she testified at trial that she relayed
the information regarding the boots when she was complet-
ing the accident report, which is written partly in English and
partly in Spanish. The compensation court assessed Duenas’
credibility and believed her version. The court was not clearly
wrong in doing so.
Papillion Foods also argues that Duenas’ injury did not
arise out of her employment because her preexisting arthritis
in her left knee was a personal risk that caused her injury in
a manner that was not unexpected or unforeseen. Arnold sup-
ports this argument, stating that Duenas’ meniscus tear was
a “tear of attrition,” which was a natural progression of her
preexisting arthritis. And Papillion Foods argues that Conroy’s
opinion that “her meniscus tear may be some degree [fresh]
rather than a chronic root tear that comes with arthritis”
is insufficient to prove causation. (Emphasis supplied.) We
acknowledge that medical opinions couched in terms of pos-
sibility are insufficient. See Edmonds v. IBP, inc., 239 Neb.
899, 479 N.W.2d 754 (1992). However, Conroy also opined,
to a reasonable degree of medical certainty, that Duenas’ pain
and disability were related to her fall at work, adding, “I rec-
ognize she has pre-existing arthritis but that was not affecting
her before the fall according to the patient.” In a response of
August 21, 2022, Conroy attributed Duenas’ knee injury to the
oversized boots.
The compensation court accepted Duenas’ testimony, as
well as Conroy’s opinion that the pain and disability she was
experiencing were due to the work-related accident, and we
cannot find that it was clearly wrong to do so. The compensa-
tion court did not err in determining Duenas’ injury arose out
of and in the course of her employment.

- 911 -
Nebraska Court of Appeals Advance Sheets
32 Nebraska Appellate Reports
VENTURA DUENAS v. PAPILLION FOODS
Cite as 32 Neb. App. 899
Conroy’s Opinion.
Papillion Foods assigns that the compensation court erred in
adopting Conroy’s opinion not only on causation as addressed
above, but also on the nature and extent of Duenas’ injury.
Papillion Foods argues that Conroy did not consider Duenas’
prior workers’ compensation claims and collateral informa-
tion 	that 	Duenas’ low-back 	pain 	had 	resolved; 	therefore,
the compensation court should have discredited his opinion.
We disagree.
We recognize that there was evidence that Duenas had pre-
vious workers’ compensation claims regarding her knees and
back, but there was also evidence that those body parts were
not causing Duenas any pain or disability just prior to the
April 8, 2021, injury. We find no error in the court’s reliance
upon Conroy’s opinion because even considering those prior
claims, her health status immediately prior to her accident
refutes any continuing issues.
Papillion Foods also argues that Duenas had reported that
her back pain had resolved as evidenced by a progress note of
June 23, 2022, which indicated she had scheduled an appoint-
ment for back pain, but she no longer had that discomfort.
When Papillion Foods advised Conroy of this, he responded
that he did not see written material indicating back pain resolu-
tion, but if he had, it would affect his opinion.
However, 	other 	evidence 	in 	the 	record 	indicates 	that
Duenas’ back pain had not completely resolved by June 2022.
Conroy treated Duenas on July 12 for knee pain. In his notes
from that visit, he stated that her right knee arthritis has
“been exacerbated by the injury in her left knee which is [sic]
also caused her back to hurt.” We note, however, that under
the heading “Review of Systems,” she was listed as being
“[n]egative for back pain.” Furthermore, in Stricklett’s loss
of earning capacity report of October, he noted that Duenas
stated she had “‘a lot of pain in [her] back. . . . [Her] back is
really bad so [she] must use a walker.’”

- 912 -
Nebraska Court of Appeals Advance Sheets
32 Nebraska Appellate Reports
VENTURA DUENAS v. PAPILLION FOODS
Cite as 32 Neb. App. 899
Papillion Foods’ argument is that Conroy’s opinion would
have changed if he had known Duenas’ low-back pain had
resolved in June 2022. There is evidence, however, that her
low-back pain had not resolved. Therefore, we cannot say
that Conroy’s opinion regarding Duenas’ continued back pain
is refuted by the record, nor that the compensation court was
clearly wrong in adopting his opinion.
Permanent and Total Disability and Rule 11.
In its last two assigned errors, Papillion Foods assigns that
the compensation court erred in finding Duenas permanently
and totally disabled and that its order did not comply with Rule
11 of the compensation court rules of procedure. Because our
resolution of these two issues is related, we will address these
assigned errors together.
[15-18] Temporary disability benefits under the Nebraska
Workers’ Compensation Act are discontinued at the point of
maximum medical improvement, because a disability cannot be
both temporary and permanent at the same time. Krause v. Five
Star Quality Care, 301 Neb. 612, 919 N.W.2d 514 (2018). The
date of maximum medical improvement for purposes of ending
a workers’ compensation claimant’s temporary disability is the
date upon which the claimant has attained maximum medical
recovery from all of the injuries sustained in a particular com-
pensable accident. Id. When an injured employee has reached
maximum medical improvement, any remaining disability is,
as a matter of law, “permanent,” within the meaning of the
Nebraska Workers’ Compensation Act. Krause v. Five Star
Quality Care, supra. Whether a workers’ compensation claim-
ant has reached maximum medical improvement is a question
of fact. Id.
[19] Rule 11 provides in part that “[d]ecisions of the court
shall provide the basis for a meaningful appellate review. The
judge shall specify the evidence upon which the judge relies.”
Rule 11 ensures that compensation court orders are sufficiently
clear in addressing the parties’ requested relief so that an
appellate court can review the evidence relied upon by the trial

- 913 -
Nebraska Court of Appeals Advance Sheets
32 Nebraska Appellate Reports
VENTURA DUENAS v. PAPILLION FOODS
Cite as 32 Neb. App. 899
judge in support of his or her findings. Lewis v. MBC Constr.
Co., 309 Neb. 726, 962 N.W.2d 359 (2021).
Here, the compensation court found Duenas was entitled to
permanent and total disability but made no finding that she
had reached maximum medical improvement as to her knee
and back injury, the date on which that was attained, or the
evidence upon which it relied to make those determinations.
Rather, it ordered Papillion Foods to pay permanent and
total disability benefits from May 27, 2022, the date Duenas
was last employed with Papillion Foods. Our review of the
record does not reveal any correlation between that date and
a finding of maximum medical improvement by any health
care professional.
We also note that in its award, the court did not make a
specific finding as to Duenas’ physical restrictions. It noted
the loss of earning capacity evaluation by Stricklett of October
24, 2022, in which Stricklett stated that “based upon Dr.
Conroy’s restrictions of ‘sitting work only’ [Duenas] had a
loss of access to employment of 100 percent and . . . loss of
earning capacity of 100 percent.” It also recited the results of
the functional capacity evaluation of April 27, 2023, limiting
Duenas to a “medium physical demand ability” and that she
“could lift 20 to 50 pounds occasionally and 10 pounds con-
stantly”; however, the award does not make a finding of what
Duenas’ physical restrictions actually are. Papillion Foods
argues that without guidance as to what her permanent restric-
tions are, it is unable to later seek a modification pursuant to
Neb. Rev. Stat. § 48-141 (Reissue 2021). We agree.
Because the award does not specify whether the compensa-
tion court had found Duenas at maximum medical improve-
ment, the date on which that would have occurred, the extent
of her permanent physical restrictions, or the evidence it relied
upon in reaching those findings, it does not provide for mean-
ingful appellate review on the issue of permanent and total
disability. Because proof of permanent impairment of the body
as a whole is a predicate to a determination of loss of earn-
ing capacity, the absence of a finding of maximum medical

- 914 -
Nebraska Court of Appeals Advance Sheets
32 Nebraska Appellate Reports
VENTURA DUENAS v. PAPILLION FOODS
Cite as 32 Neb. App. 899
improvement precludes the court’s determination of Duenas’
loss of earning capacity. See Visoso v. Cargill Meat Solutions,
285 Neb. 272, 826 N.W.2d 845 (2013). In other words, with-
out a finding of maximum medical improvement, loss of
earning capacity and permanent and total disability cannot be
determined. Furthermore, without identifying Duenas’ perma-
nent physical restrictions, Papillion Foods is hindered in its
ability to seek a later modification if her condition improves.
We therefore vacate that portion of the court’s award relating
to the award of permanent and total disability payments and
remand the cause to the compensation court with directions
to issue an award that complies with Rule 11. Papillion Foods
points to various conflicting evidence that it states the com-
pensation court failed to rule upon or address in addition to
the issue of maximum medical improvement, and it argues that
this shows the award does not provide for meaningful appel-
late review. We reject those arguments. The award addressed
the evidence presented by both parties, including how the
injury occurred, the medical treatment Duenas received, and
the opinions of the professionals who examined Duenas and
were involved in her care. Aside from the issues of maximum
medical improvement, permanent and total disability status,
and the extent of her restrictions, the award allows for mean-
ingful appellate review and thus complies with Rule 11.
Attorney Fees.
Duenas requests that we award her attorney fees pursuant
to Neb. Rev. Stat. § 48-125(4)(b) (Reissue 2021). Because we
are in part vacating the award, we deny her request.
CONCLUSION
We vacate the compensation court’s finding of permanent
and total disability and remand the cause to the compensation
court with directions to enter an order in compliance with Rule
11. We affirm the award in all other respects.
Affirmed in part, and in part vacated
and remanded with directions.